Injury Illness Prevention Plan - Flipbook - Page 69
14.0 TEAMMATE ACKNOWLEDGEMENT FORM
I have fully read and understand TEAMWRKX Construction’s INJURY & ILLNESS
PREVENTION PROGRAM and all of its contents contained therein. I agree to abide by its
policies and terms, guidelines, code of safe practices and protocol as a condition of my
employment.
PRINT FULL NAME: ______________________________________________________
SIGNATURE: ___________________________________________________________
SOCIAL SECURITY/ID #: ___________________________________________________
DATE: ___________________
Revised: October 2023
68
